Carlin Arthur M, O'Connor Elizabeth A, Genaw Jeffrey A, Kawar Sameeh
Department of Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
Surg Obes Relat Dis. 2008 Jul-Aug;4(4):481-5. doi: 10.1016/j.soard.2007.09.010. Epub 2007 Dec 11.
Identification of preoperative predictors of weight loss after laparoscopic Roux-en-Y gastric bypass (LRYGB) can lead to improved clinical outcomes. The purpose of this study was to determine whether preoperative weight loss was associated with improved percentage of excess weight loss (%EWL) 1 year after LRYGB.
A retrospective analysis was performed on the data from 295 patients who had undergone LRYGB at our institution from July 2004 to November 2005. Routine preoperative weight loss goals were implemented to facilitate the laparoscopic approach and ensure compliance with an appropriate nutritional and exercise program. Patients with an initial consultation BMI of <50, 50-59, and > or =60 kg/m(2) were given weight loss goals of 5 lb and 5% and 10% of body weight, respectively.
The mean age was 45 +/- 10 years, and 89% were women and 70% were white. The mean BMI at the initial consultation was 51 +/- 7 kg/m(2). A significant inverse correlation was found between the preoperative BMI and %EWL at 1 year postoperative (P <.001). When controlling for BMI, no correlation was found between the %EWL and percentage of preoperative weight loss or attainment of the weight loss goals. The weight loss goals were met or surpassed by 79% of patients, and the mean %EWL at 1 year was 66%. Whites had greater %EWL at 1 year postoperatively compared with African Americans (67% versus 61%; P = .002). When controlling for age, gender, race, and consultation BMI, the preoperative weight loss did not predict for the %EWL at 1 year.
The results of this study have shown that preoperative weight loss does not predict postoperative weight loss 1 year after LRYGB. A lower BMI, younger age, and white race predicted better %EWL.
识别腹腔镜Roux-en-Y胃旁路术(LRYGB)后体重减轻的术前预测因素可改善临床结局。本研究的目的是确定术前体重减轻是否与LRYGB术后1年的超重减轻百分比(%EWL)改善相关。
对2004年7月至2005年11月在本机构接受LRYGB的295例患者的数据进行回顾性分析。实施常规术前体重减轻目标以促进腹腔镜手术入路,并确保遵守适当的营养和运动计划。初次咨询时BMI<50、50 - 59和≥60 kg/m²的患者,分别给予5磅以及体重5%和10%的体重减轻目标。
平均年龄为45±10岁,89%为女性,70%为白人。初次咨询时的平均BMI为51±7 kg/m²。术后1年时,术前BMI与%EWL之间存在显著负相关(P<.001)。在控制BMI后,未发现%EWL与术前体重减轻百分比或体重减轻目标的达成情况之间存在相关性。79%的患者达到或超过了体重减轻目标,1年时的平均%EWL为66%。与非裔美国人相比,白人术后1年的%EWL更高(67%对61%;P =.002)。在控制年龄、性别、种族和咨询时的BMI后,术前体重减轻并不能预测1年时的%EWL。
本研究结果表明,术前体重减轻不能预测LRYGB术后1年的体重减轻情况。较低的BMI、较年轻的年龄和白人种族预示着更好的%EWL。